Provider Demographics
NPI:1245214675
Name:CUNNINGHAM, PAUL JAMES (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JAMES
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2722 MERRILEE DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4420
Mailing Address - Country:US
Mailing Address - Phone:703-698-4444
Mailing Address - Fax:703-698-2176
Practice Address - Street 1:2722 MERRILEE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4420
Practice Address - Country:US
Practice Address - Phone:703-698-4444
Practice Address - Fax:703-698-2176
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00539562085R0202X
VA01012461652085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101246165OtherMEDICAL LICENSE